Teen Sexual and Reproductive Health in New York City

Transcription

1 1 Teen Sexual and Reproductive Health in New York City Citizens Committee for Children of NY Policy Briefing October 23 rd, 2013 Deborah Kaplan, DrPH, MPH, R-PA Assistant Commissioner Bureau of Maternal, Infant and Reproductive Health NYC Department of Health and Mental Hygiene

2 2 A Youth Development Framework Provide teens with the information, skills and resources they need to make healthy decisions

3 Teen Pregnancy is More Common in the Bronx, NYC and the United States than in Most Other Industrialized Countries 3 Teen Pregnancy, rate per year old females, Bronx, NYC, U.S., and Europe

4 4 Teen Pregnancy in NYC Each year, 17,000 NYC teens ages become pregnant Many do not know where to go for confidential services Limited awareness of and access to highly effective contraceptive methods Many providers serving teens do not offer reproductive health services during primary care visits

5 5 About 9 in 10 teen pregnancies in NYC are unintended Sources: Bureau of Maternal, Infant & Reproductive Health calculations, using data from the Bureau of Vital Statistics, the NYC Pregnancy Risk Assessment Monitoring System (PRAMS), and unpublished Guttmacher Institute analyses of the National Survey of Family Growth

6 6 NYC s teen pregnancy rate has declined 30% since 2001

7 The poorest neighborhoods have the highest teen pregnancy rates 7

8 Rates among black and Hispanic teens are 4-7 times higher than rates among white & Asian teens 8

9 The percent of public high school students who ever had sex has declined 26% since

10 Use of hormonal birth control or long-acting reversible contraception (LARC) increased among sexually active female public high school students over the past two years 10

11 DOHMH Four-Pronged Strategy to Reduce Unintended Teen Pregnancy 11 Evidence-Based Programs (Sex Education, Youth Development) Clinic Linkage Quality Sexual & Reproductive Health Services Community/Stakeholder Education & Engagement Delay Initiation of Sex/ 2 o Abstinence Increase Contraceptive Use Among Sexually Active Teens Reduce Unintended Teen Pregnancy

12 DOHMH s programs are concentrated in neighborhoods with the highest teen pregnancy rates 12 DOHMH Adolescent Reproductive Health Programs and Pregnancy Rates Among NYC Residents Ages 15-19, by United Hospital Fund (UHF) Area, 2009

13 13 What are we doing citywide? Best clinical practices and Clinic Linkage Teens in NYC (TNYC) Portal Preferred Referral Guide Mobile App/Clinic locator Family Planning Benefit Program presumptive eligibility Public Awareness Campaigns Dual protection Contraception Tear-off sheet

14 Teens in NYC mobile app launch 14 YOU CAN DOWNLOAD THE APP NOW!

15 Community and Stakeholder Engagement: Public Awareness Campaign 15

16 16 School-Based Health Center Reproductive Health Project Increasing access to reproductive health services, including contraceptive methods onsite 39 out of 44 public high school SBHCs are participating (serving 67,000 = ~25% of public HS students) Coordination with 19 implementing agencies SBHC providers receive training and technical assistance on evidence-based practices for adolescents, including on-site contraception

17 17 Connecting Adolescents to Comprehensive Healthcare (CATCH) First in the country to provide critical reproductive health services using existing school nurses and physicians Pregnancy Testing Emergency Contraception (EC) Oral Contraception (birth control pills) and condoms Referrals to Community-based Clinics Reproductive health education and counseling Offer services in schools without SBHCs: ~100 high school sites

18 18 Bronx Teens Connection Multicomponent program to reduce unintended teen pregnancy in the South Bronx

19 19 NYC Nurse-Family Partnership Nurse-Family Partnership (NFP) is an evidence-based, nationwide nurse home visiting program Improves the health, well-being and self-sufficiency of low-income first-time mothers and their children NYC NFP is the largest urban site in the country >10,000 clients since its 2003 inception, > 40% teens NYC NFP teen clients versus comparable NYC teens Higher rates postpartum contraception and use of the most effective contraceptive methods Fewer closely-spaced pregnancies Higher rates high school graduation or receipt of GED

20 NYC NURSE-FAMILY PARTNERSHIP 20 Proud high school grad and NFP client Raquel Liriano- Garcia shares her special day in June 2013 with 6- month-old daughter Leslie. Liriano-Garcia, 18, started classes at Lehman College this fall. Her graduation from the NFP program will be in December 2014, when Leslie turns two.

21 21 Minor s Right to Confidential Services in NYS Minor s have the right to confidential sexual and reproductive health services without the consent of a parent or guardian Many teen-friendly free or low cost health services Many safe, effective contraceptive methods available for teens to prevent unintended pregnancy

22 Take Care New York (TCNY) Goal: Decrease teen pregnancy 15% by 2016 Healthcare Providers Establish routine screening for sexual activity and contraception at all visits with adolescents Provide appropriate services and resources or referrals Youth-Serving Organizations Establish and build relationship with teen-accessible clinics Advocate for Medicaid reimbursement for immediate post-abortion and post-partum contraception 22

23 23 The best contraceptive is a real future Marian Wright Edelman